John Tesco Goodson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3494093501 Issued in UT

Practice address

791 N. Pepper Ave
Colton, CA 92324

Phone

(909) 824-0480

Fax

(909) 824-0487

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• LDS Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colton, CA
  • NPI 1386765345
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1124149117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "791 N. PEPPER AVE.",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "92324",
            "telephone_number": "909-824-0480",
            "fax_number": "909-824-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 N. PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "92324",
            "telephone_number": "909-824-0480",
            "fax_number": "909-824-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODSON",
        "first_name": "JOHN",
        "middle_name": "TESCO",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "3494093501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES - STATE OF CALIFORNIA",
            "identifier": "ACSW 28988",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Uriel Angel Gonzalez, LMFT
• Yudith Gonzalez
• Good Times Dental, Professional Corporation
• David Goodman
• Marijo Goodsite, PA
• Bennie Gordon Jr.
• Keith L Gordon III, M.D.
• Mehrnoush Gorjian, M.D.
• Linda Kay Gory
• Katanya Katrina Goswell

• Clinical Social Worker in Colton, CA
• Providers in Colton, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.